Centers for Disease Control and Prevention

National Center for HIV, Viral Hepatitis, STD, and TB Prevention

Tuberculosis (TB) in the United States

1993–2021*

Division of Tuberculosis Elimination

National Tuberculosis Surveillance System

*Data updated as of July 8, 2022
Progress Towards TB Elimination, United States, 1982–2021

0

5000

10000

15000

20000

25000

30000

1982 1985 1988 1991 1994 1997 2000 2003 2006 2009 2012 2015 2018 2021

Number of cases

Year

Elimination threshold: ~330 cases or <1 case per 1,000,000 population

26,673 TB cases in 1992

Incidence rate: 10.4 per 100,000

7,882 TB cases in 2021

Incidence rate: 2.4 per 100,000
TB Cases and Incidence Rates, United States, 1993–2021

0

2

4

6

8

10

0

5,000

10,000

15,000

20,000

25,000

1993 1997 2001 2005 2009 2013 2017 2021

Cases per 100,000 persons

Number of cases

Year

 Number of cases Incidence rate
3.6 3.4

3.2 3.0 2.9 3.0 2.9 2.8 2.8 2.7

2.2 2.4

0

1

2

3

4

Cases per 

100,000 persons

TB Incidence Rates and Annual Percent Change in Rate, 

United States, 2010–2021

-6.1 -6.0

-4.5 -2.4

0.9

-3.8 -2.5 -1.3 -1.6

-20.2

9.8

-25

-15

-5

5

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

Annual percentage 

change in rate

*

Year *Annual percent change in rate based on unrounded data
TB-Related Deaths* and Mortality Rates, United States, 1993–2020

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0

400

800

1,200

1,600

2,000

1993 1996 1999 2002 2005 2008 2011 2014 2017 2020

Deaths per 100,000 persons

Number of deaths

Year

Number of deaths Mortality rate

*National Vital Statistics System Underlying Cause of Death (based on deaths reported through 2020)

600 TB-related deaths in 

2020
TB Cases by Reporting Area, United States, 2021

Texas 

13%

California 

22%

New York*

9%

Number of TB cases

≤99

100–299

300–999

≥1000

Florida 

6%

* Includes New York City
TB Incidence Rates* by Reporting Area, United States, 2021

Texas

3.4

California

4.5

New Jersey

3.2

Maryland 

3.2

Delaware

4.1

New York

3.4†

*Cases per 100,000 persons

†Includes New York City

Hawaii

7.4

Alaska

7.9

District of Columbia

2.7

1.5–<3.0

≥4.5

3.0–<4.5

Incidence rate

<1.5

Washington

2.6
TB Cases and Incidence Rates*

by Reporting Area, United States, 2021

*Cases per 100,000 persons

0 states with low incidence and high case count

Incidence rate*

≥3.4

1.7–<3.4

<1.7

Case count
Top 10 TB Incidence Rates* by Metropolitan Statistical Areas 

(MSAs), United States, 2021

*Cases per 100,000 persons

San Francisco

5.8

San Jose

6.9

Honolulu

8.6

Stockton

5.2

Houston 

4.2

San Diego

6.1

Fresno

4.4

New York City

4.2

Los Angeles

4.9

<1.5

1.5–<3.0

≥4.5

3.0–<4.5

Incidence rate*

Bakersfield

4.6
TB Incidence Rates* by U.S.-Affiliated Pacific Islands, 2021

*Cases per 100,000 persons
TB Cases and Incidence Rates by Origin of Birth,*

United States, 1993–2021

0

5

10

15

20

25

30

35

40

0

5,000

10,000

15,000

20,000

25,000

30,000

1993 1997 2001 2005 2009 2013 2017 2021

Cases per 100,000 persons

Number of cases

Year

 U.S.-born persons

Non-U.S.–born persons

 U.S.-born rate

Non-U.S.–born rate

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
0.0

0.4

0.8

1.2

1.6

2.0

2011 2013 2015 2017 2019 2021

Cases per 100,000 persons

Year

U.S.-born

11% increase from 

2020 to 2021

TB Incidence Rates by Origin of Birth,* United States, 2011–2021 

0

4

8

12

16

20

2011 2013 2015 2017 2019 2021 Year

Non-U.S.–born

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

7% increase from 

2020 to 2021
TB Incidence Rates and Percentages by Origin of Birth,*

United States, 2021 (N=7,849)

U.S.-born, 28% 

(Rate: 0.8 per 100,000)

Non-U.S.–born 71%

(Rate: 12.5 per 100,000)

–

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

Origin of birth unknown, <1%
TB Cases by Countries of Birth Among Non-U.S.–Born* Persons with 

TB, United States, 2021 (N=5,626)

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

600 +

N/A

0 - 49

50 - 99

100 - 249

250 - 399

400 - 599

India

10% Vietnam

8%

Mexico 

19%

China

6%

Philippines

12%
Top 10 TB Incidence Rates* by Country of Birth, 

United States, 2017–2021

* Cases per 100,000 persons

47

51

59

61

70

70

70

77

101

170

Ethiopia

Guinea

Federated States of Micronesia

Nepal

Somalia

Myanmar

Bhutan

Mongolia

Republic of the Congo

Republic of the Marshall Islands
Percentage of TB Cases Among Non-U.S.–Born* Persons by Years 

Since Initial Arrival in the United States at Diagnosis,† 2021 (N=5,626)

10%

15%

14%

10%

7%

9%

6%

6%

4%

9%

<1 year

1-4 years

5–9 years

10–14 years

15–19 years

20–24 years

25–29 years

30–34 years

35–39 years

≥40 years

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†The number of years since initial arrival in the United States at diagnosis was unknown or missing for 11% of non-U.S.–born persons. These persons were included in the denominator when 

calculating percentages.
0

2,000

4,000

6,000

8,000

10,000

12,000

2011 2013 2015 2017 2019 2021

Number of cases

Year

TB Cases by Race/Ethnicity,* United States, 2011–2021

*Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."

Black or African American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Hispanic or Latino
Percentage of TB Cases by Race/Ethnicity,* United States, 2011–2021

0%

20%

40%

60%

80%

100%

2011 2013 2015 2017 2019 2021

Percentage of cases

Year

Black or African American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Hispanic or Latino

*Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."
Percentage of TB Cases by Race/Ethnicity,* 

United States, 2021 (N=7,882)

36%

31%

18%

11%

1%

1%

1%

<1%

Asian

Hispanic or Latino

Black or African American

White

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

Multiple race

Unknown or missing

*Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."
0

5

10

15

20

25

2011 2013 2015 2017 2019 2021

Cases per 100,000 persons

Year

Native Hawaiian or Other 

Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Black or African American

Hispanic or Latino

TB Incidence Rates by Race/Ethnicity,* United States, 2011–2021

*Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Cases Among U.S.-Born* Persons by Race/Ethnicity,†

United States, 2011–2021

0

1,000

2,000

3,000

4,000

2011 2013 2015 2017 2019 2021

Number of cases

Year

Black or African American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Hispanic or Latino

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Incidence Rates Among U.S.-Born* Persons by 

Race/Ethnicity,† United States, 2011–2021

0

1

2

3

4

5

6

7

2011 2013 2015 2017 2019 2021

Cases per 100,000 persons

Year

Native Hawaiian or

Other Pacific Islander

American Indian or

Alaska Native

Asian

Multiple Race

White

Black or African American

Hispanic or Latino

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Cases Among Non-U.S.–Born* Persons by Race/Ethnicity,†

United States, 2011–2021

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

2011 2014 2017 2020

Number of cases

Year

Black or African American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Hispanic or Latino

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Incidence Rates Among Non-U.S.–Born* Persons by 

Race/Ethnicity,† United States, 2011–2021

0

10

20

30

40

50

2011 2013 2015 2017 2019 2021

Cases per 100,000 persons

Year

Native Hawaiian or Other 

Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Black or African American

Hispanic or Latino

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Incidence Rates Among Non-U.S.–Born and U.S.-Born* Persons by 

Race/Ethnicity,† United States, 2011–2021

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by selfreported race; if more than one race was reported, the person was categorized as "Multiple race."

§Non-U.S-born American Indian/Alaska Native are not displayed because some years have zero cases, which cannot be displayed in a log-scale graph.

0

1

10

100

2011 2013 2015 2017 2019 2021

Cases per 100,000 persons

Year

2011 2013 2015 2017 2019 2021

Year

American Indian or

Alaskan Native

Asian

Black or African

American

Hispanic or Latino

Multiple races

Native Hawaiian or

Other Pacific Islander

White

Non-U.S.–born U.S.–born §
Percentage* of TB Cases by Origin† and Race/Ethnicity,§

United States, 2021

*Percentages are rounded. Percentages of unknowns/missing are <1% and are not displayed in graphs.

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

§Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race.

Non-U.S.–born persons

(N=5,626)

U.S.-born persons 

(N=2,223)

4%

1%

2%

29%

34%

24%

6%

Native Hawaiian or 

Other Pacific Islander

American Indian or 

Alaska Native

Multiple Race

White

Hispanic or Latino

Black or

African American

Asian

1%

1%

4%

12%

33%

48%

0%
TB Incidence Rates* by Origin† and Race/Ethnicity,§

United States, 2021

*Cases per 100,000 persons

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

§Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."

Non-U.S.–born persons

(N=5,626)

U.S.-born persons 

(N=2,223)

Native Hawaiian or 

Other Pacific Islander

White

Black African or 

American

Hispanic or Latino

3.8

0.3

5.7

0.3

2.1

1.3

1.5

American Indian or 

Alaska Native

Multiple Race

Asian

1.3

30.2

22.0

3.1

15.2

8.9

23.8 Asian
TB Cases by Age Group, United States, 1993–2021

0

5,000

10,000

15,000

20,000

25,000

1993 1997 2001 2005 2009 2013 2017 2021

Number of cases

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years
0

5

10

15

20

1993 1997 2001 2005 2009 2013 2017 2021

Cases per 100,000 persons

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years

TB Incidence Rates by Age Group, United States, 1993–2021
TB Cases Among U.S.-Born* Persons by Age Group, 

United States, 1994–2021

0

4,000

8,000

12,000

16,000

1994 1997 2000 2003 2006 2009 2012 2015 2018 2021

Number of cases

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
TB Incidence Rates* Among U.S.-Born† Persons by Age Group, 

United States, 1994–2021

0

4

8

12

16

1994 1997 2000 2003 2006 2009 2012 2015 2018 2021

Cases per 100,000 persons

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years

*Population Source: U.S. Census Bureau, Current Population Survey Basic Monthly: https://data.census.gov/mdat/

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
TB Cases Among Non-U.S.–Born* Persons by 

Age Group, United States, 1994–2021

0

2,000

4,000

6,000

8,000

1994 1997 2000 2003 2006 2009 2012 2015 2018 2021

Number of cases

Year

0–4 years 5–14 years 15–24 years 25–44 years 45–64 years ≥65 years

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
TB Incidence Rates* Among Non-U.S.–Born† Persons by 

Age Group, United States, 1994–2021

0

10

20

30

40

50

60

70

1994 1997 2000 2003 2006 2009 2012 2015 2018 2021

Cases per 100,000 persons

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years

*Population Source: U.S. Census Bureau, Current Population Survey Basic Monthly: https://data.census.gov/mdat/

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Percentage of TB Cases by Birth Decade Among U.S.-Born* Persons, 

United States, 1993–2021

0%

20%

40%

60%

80%

100%

1993 1997 2001 2005 2009 2013 2017 2021

Percentage of TB cases

Year

2010s

2000s

1990s

1980s

1970s

1960s

1950s

1940s

1930s

1920s

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Percentage of TB Cases by Birth Decade Among Non-U.S.–Born* 

Persons, United States, 1993–2021

0%

20%

40%

60%

80%

100%

1993 1997 2001 2005 2009 2013 2017 2021

Percentage of TB cases

Year

2010s

2000s

1990s

1980s

1970s

1960s

1950s

1940s

1930s

1920s

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Percentage of TB Cases by Sex and Age Group, United States, 2021

Males (N=4,827) Females (N=3,052)

64%

65%

59%

53%

46%

53%

36%

35%

41%

47%

54%

0–4 years (N=160) 48%

5–14 years (N=157)

15–24 years (N=675)

25–44 years (N=2,266)

45–64 years (N=2,409)

≥65 years (N=2,215)

Age group
Pediatric TB Cases by Origin of Birth,* United States, 1993–2021

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

1993 1997 2001 2005 2009 2013 2017 2021

Number of cases

Year

Non-U.S.–born

U.S.-born

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Pediatric TB Incidence Rates* by Origin of Birth,†

United States, 1994–2021

0

4

8

12

16

20

24

28

32

36

40

44

48

52

56

60

64

1994 1997 2000 2003 2006 2009 2012 2015 2018 2021

Cases per 100,000 persons

Year

Non-U.S.–born, 0–4 years

Non-U.S.–born, 5–14 years

U.S.-born, 0–4 years

U.S.-born, 5–14 years

*Population Source: U.S. Census Bureau, Current Population Survey Basic Monthly: https://data.census.gov/mdat/

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–

born.
TB Cases by Case Verification Criteria, United States, 1993–2021

0

5,000

10,000

15,000

20,000

25,000

30,000

1993 1997 2001 2005 2009 2013 2017 2021

Number of cases

Year

Positive culture

Positive NAA* test

Positive smear

Clinical case

Provider diagnosis

*NAA=nucleic acid amplification

Positive NAA* test
Percentage TB Cases by Case Verification Criteria,

United States, 2021 (N=7,882)

79%

13%

4%

3%

<1%

Positive culture

Clinical case

Provider diagnosis

Positive NAA* test

Positive smear

*NAA=nucleic acid amplification
Percentage of TB Cases by Site of Disease,* United States, 2021

Pulmonary 

involvement,

†

79% Extrapulmonary 

only, 21%

*Patients may have more than one disease site but are counted in mutually exclusive categories for surveillance purposes. 

†

Any pulmonary involvement which includes cases that are pulmonary only and both pulmonary and extrapulmonary. 

27%

<1%

4%

4%

7%

14%

15%

31%

Other

Laryngeal

Meningeal

Genitourinary

Peritoneal

Bone and joint

Pleural

Lymphatic
0%

20%

40%

60%

80%

100%

1993 1996 1999 2002 2005 2008 2011 2014 2017 2020

Percentage of cases

HRZE† Other 4+ drug regimen§ Not on a 4+ drug regimen

Year

Percentage of TB Cases* by Initial Drug Regimen, 

United States, 1993–2021

*Persons alive at diagnosis with initial drug regimen information.

†H, isoniazid; R, rifampin; Z, pyrazinamide; E, ethambutol.

§A drug regimen with at least four drugs, other than HRZE.

HRZE† Other 4+ drug regimen§
HRZE¶

, 83%

Not on a 4+ drug regimen, 6%

Other 4+ drug regimen§, 10%

Percentage* of TB Cases† by Initial Drug Regimen, United States, 

2021 (N=7,604)

*Percentages do not total to 100% due to rounding.

†Persons alive at diagnosis with initial drug regimen information.

§A drug regimen with at least four drugs, other than HRZE.

¶H, isoniazid; R, rifampin; Z, pyrazinamide; E, ethambutol.
*Persons on an initial drug therapy with at least one drug.

†Most recent year for which data are complete.

§DOT=directly observed therapy; SAT=self-administered therapy.

Percentage of TB Cases by Mode of Treatment Administration,*

United States, 1993–2019†

0%

20%

40%

60%

80%

100%

1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019

Percentage of cases

Year

DOT§ only DOT + SAT SAT only § only DOT and SAT§
Percentage of TB Cases* by Mode of Treatment Administration, 

United States, 2019† (N=8,632)

Directly-observed 

therapy (DOT) only, 62%

DOT + SAT, 33%

Self-administered therapy (SAT) only, 5%

*Persons alive at diagnosis with initial drug regimen information

†Most recent year for which data are complete.
0%

20%

40%

60%

80%

100%

1993 1998 2003 2008 2013 2018

Percentage of cases

Year

Completed in ≤1 year Completed Did not complete National 

Goal§:

95%

Percentage of TB Cases* by Completion of TB Therapy,

United States, 1993–2019†

*Persons alive at diagnosis who started TB therapy and for whom therapy <1 year was indicated.

†Most recent year for which data are complete.

§National goal: for 95% of patients with newly diagnosed TB disease for whom ≤12 months of treatment is indicated to complete treatment within 12 months.
Percentage of TB Cases* by Reason Therapy Stopped, 

United States, 2019† (N=8,632)

Completed therapy, 87%

Did not complete 

therapy, 13%

21%

2%

8%

11%

57%

Other

Adverse event

Refusal

Lost to follow-up

Died

*Persons alive at diagnosis taking one or more TB drugs.

†Most recent year for which data are complete

§Reason therapy stopped reported as other, unknown, or missing.

Reasons therapy stopped

Other§
TB Cases Resistant to Isoniazid* by Origin of Birth,†

United States, 1993–2021

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

1993 1997 2001 2005 2009 2013 2017 2021

Number of cases

Year

U.S.-born

Non-U.S.–born

*Persons with isolates resistant to at least isoniazid among persons with isolates tested with at least isoniazid and rifampin. †Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Number and Percentage of Multidrug-Resistant (MDR)* TB Cases by 

History of TB, United States, 1993–2021

0%

1%

2%

3%

0

100

200

300

400

500

1993 1997 2001 2005 2009 2013 2017 2021

Percentage of cases

Number of cases

Year

 No previous TB

 Previous TB

 Percentage MDR with no previous TB

*Resistant to at least isoniazid and rifampin.
Percentage of HIV Coinfection by Age Among Persons with TB,*

United States, 2011–2021

0%

2%

4%

6%

8%

10%

12%

2011 2013 2015 2017 2019 2021

Percentage of cases

Year

All ages

25–44 years

45–64 years

*Persons alive at diagnosis with HIV test results
Percentage of Selected Risk Factors Among Persons with TB by 

Origin of Birth,* United States, 2021

24%

9%

6%

17%

9%

12%

27%

9%

4%

Diabetes mellitus Non-HIV immunosuppression Contact with infectious TB

Total

U.S.-born

Non-U.S.–born 

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Percentage of Social and Behavioral Risk Factors Among Persons 

Aged ≥15 Years with TB, United States, 2021

1%

2%

2%

5%

7%

8%

Injection drug use

Residing in long-term care facility†

Residing in correctional facility

Experiencing homelessness

Noninjection drug use

Excess alcohol use

*

Within past 12 months prior to TB diagnosis

†At the time of TB diagnosis

Excess alcohol use*

Noninjecting drug use*

Experiencing homelessness*

Residing in correctional facility†

Residing in long-term care facility†

Injecting drug use*
*Correctional facilities include federal prisons, state prisons, local jails, juvenile correctional facilities, other correctional facilities, and unknown or missing types of correctional facility.

Number and Percentage of Correctional Facility* Residents Among 

Persons Aged ≥15 Years with TB, United States, 1993–2021

0%

1%

2%

3%

4%

5%

6%

0

200

400

600

800

1,000

1,200

1993 1997 2001 2005 2009 2013 2017 2021

Percentage of cases

Number of cases

Year

 Number of cases

 Percentage of cases
TB Cases Among Correctional Facility Residents Aged ≥15 Years 

by Type of Facility, United States, 1993–2021 

*Includes Immigration and Customs Enforcement (ICE) detention centers, Indian reservation facilities (e.g., tribal jails), military stockades and jails, federal park police facilities, police 

lockups (temporary holding facilities for persons who have not been formally charged in court), or other correctional facilities that are not included in the other specific choices

0

200

400

600

800

1,000

1,200

1993 1997 2001 2005 2009 2013 2017 2021

Number of cases

Year

Federal prison

State prison

Local jail

Juvenile correction facility

Other*

Unknown

Other*
TB Cases Among Correctional Facility Residents Aged ≥15 Years 

by Type of Facility, United States, 2021 

Federal Prisons

Number 

of cases

State Prisons

Local Jails Other Facilities

Number 

of cases

Number 

of cases

Number 

of cases

28

1

15

1

6

1

21

1
Percentage of TB Cases by Primary Occupation* 

Among Persons Aged ≥15 Years, United States, 2021 (N=5,795) 

21%

20%

15%

4%

1%

<1%

38%

Unemployed

Retired

Not seeking employment

Healthcare worker

Migrant worker

Correctional employee

Other

*Within past 12 months prior to TB diagnosis.
Dead at diagnosis

(N=221)

Died after diagnosis

(N=671)

23%

48%

29%

21%

42%

37% TB cause of 

death

TB not cause 

of death

Unknown 

cause of death

Percentage of TB Cases by Status

and Cause of Death, United States, 2019* (N=8,898)

Alive, 90%

Dead, 10%

*Most recent year for which data are complete
Sputum Culture Conversions, United States, 2019* (N=5,047)

Documented, 87%

Culture conversion 

unknown, 1%

Not 

documented, 

12%

8%

1%

4%

10%

15%

21%

41%

Unknown

Refused

Lost to follow-up

Could not produce

Other

Sputum not

collected

Died

Reasons sputum culture 

conversion not documented

*Most recent year for which data are complete
National TB Genotyping Surveillance Coverage,*

United States, 2004–2021

0%

20%

40%

60%

80%

100%

2005 2007 2009 2011 2013 2015 2017 2019 2021

Percentage of culture confirmed 

TB cases genotyped

Year *Culture-confirmed TB cases with at least one genotyped isolate.

National 

Goal:

100%
Definitions for TB Genotyping in the United States

Initial 12-locus MIRU-VNTR:*

223325173533

Spoligotype: 

000000000003771

PCRType:

PCR00002

Additional 12-locus MIRUVNTR(MIRU2):†

444534423428

+

GENType:

G00010

Sequentially assigned 

for each unique 

spoligotype and 

initial 12-locus MIRUVNTR combination

Sequentially assigned for 

each unique spoligotype 

and 24-locus MIRU-VNTR 

combination

* MIRU-VNTR=Mycobacterial interspersed repetitive unit–variable number tandem repeat.

† The complete set of 24 loci is referred to as 24-locus MIRU-VNTR and is used for U.S. GENType designations.
836

206

95

30

18

12

11

4

29

2 cases

3 cases

4 cases

5 cases

6 cases

7 cases

8 cases

9 cases

≥10 cases

Number of County-based TB Genotype Clusters* by Cluster Size, 

United States, 2019–2021

* Clusters have two or more cases with matching spoligotype and 24-locus locus mycobacterial interspersed repetitive unit-variable number tandem repeat type (GENType) within a county 

during the specified 3-year time period.
TB Genotype Clusters by TB GIMS* Alert Levels,† United States, 

2019–2021 (N=1,241)

High alert, 5%

Medium alert, 22%

No alert, 73%

* TB GIMS=Tuberculosis Genotyping Information Management System

† Alert levels are based on a log-likelihood ratio, which calculates the geographical concentration of a genotype in a county compared to the rest of the country during a 3-year period. TB 

GIMS generates alert level notifications based on this statistic: “No alert” is indicated if LLR is between 0–<5, “medium” is for LLR of 5–<10 and “high” alert is for clusters with LLR ≥10.
Genotyped TB Cases Estimated to be Attributed to Recent Transmission, 

United States, 2020–2021 (N=11,404)

4%

8%

Not recent 

transmission,§ Limited recent transmission 88%

Extensive recent transmission†

* A TB case is designated as attributed to recent transmission if a plausible source case can be identified in a person who i) has the same M. tuberculosis genotype, ii) has an infectious form of 

TB disease, iii) resides within 10 miles of the TB case, iv) is 10 years of age or older, and v) was diagnosed within 2 years before the TB case.

† A TB case is designated as attributed to extensive recent transmission when the criteria above for recent transmission are met, and furthermore the case belongs to a plausible transmission 

chain of six or more cases. Otherwise, the case is designated as attributed to limited recent transmission.

§ Cases not attributed to recent transmission may be misclassified in children <5 years old or indeterminate in persons with a recent U.S. arrival due to limitations of the plausible-source case 

method. 

Recent 

transmission,* 12%
Genotyped Cases Estimated to be Attributed to Limited and Extensive 

Recent Transmission,* United States, 2018–2021

n=557 

(33%)

n=456

(33%)

n=1,146

(67%) n=944

(67%)

0

400

800

1,200

1,600

2,000

2018–2019 2020–2021

Cases attributed to recent 

transmission

N=1,703

N=1,400

* A TB case is designated as attributed to recent transmission if a plausible source case can be identified in a person who i) has the same M. tuberculosis genotype, ii) has an infectious form of TB 

disease, iii) resides within 10 miles of the TB case, iv) is 10 years of age or older, and v) was diagnosed within 2 years before the TB case.

† A TB case is designated as attributed to extensive recent transmission when the criteria above for recent transmission are met, and furthermore the case belongs to a plausible transmission 

chain of six or more cases. Otherwise, the case is designated as attributed to limited recent transmission.

Limited recent transmission 

Extensive recent transmission†
Percentages of TB Cases Estimated to be Attributed and Not Attributed to 

Recent Transmission* by Origin of Birth,† 2020–2021

* Cases with unknown origin of birth not shown (n=40).

† A TB case is designated as attributed to recent transmission if a plausible source case can be identified in a person who i) has the same M. tuberculosis genotype, ii) has an infectious form of 

TB disease, iii) resides within 10 miles of the TB case, iv) is 10 years of age or older, and v) was diagnosed within 2 years before the TB case.

§ Cases not attributed to recent transmission may be misclassified in children <5 years old or indeterminate in persons with a recent U.S. arrival due to limitations of the plausible-source case 

method.

25%

75%

8%

92%

Non-U.S.–born U.S.-born

Recent transmission

Not recent transmission,§

Recent transmission

Not recent transmission,§
66

Percentage of TB Cases Estimated to be Attributed to Recent 

Transmission* by Race/Ethnicity,† United States, 2018–2021

2018–2019 2020–2021

*A TB case is designated as attributed to recent transmission if a plausible source case can be identified in a person who i) has the same M. tuberculosis genotype, ii) has an infectious form of 

TB disease, iii) resides within 10 miles of the TB case, iv) is 10 years of age or older, and v) was diagnosed within 2 years before the TB case.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."

Native Hawaiian or 

Other Pacific Islander

White

Hispanic or Latino

Black or 

African American

Asian

American Indian or 

Alaska Native

40%

32%

20%

12%

13%

7%

42%

35%

20%

11%

13%

7%
67

Percentage of TB Cases Estimated to be Attributed to Extensive Recent 

Transmission* by Race/Ethnicity,† United States, 2018–2021

2018–2019 2020–2021

20%

12%

7%

4%

3%

3%

*A TB case is attributed to extensive recent transmission when the criteria for recent transmission are met and furthermore the case belongs to plausible transmission chain of 6 or more cases.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic or Latino," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by 

self-reported race; if more than one race was reported, the person was categorized as "Multiple race."

Native Hawaiian or 

Other Pacific Islander

American Indian or 

Alaska Native

White

Hispanic or Latino

Black or 

African American

Asian

18%

17%

8%

4%

3%

2%
The findings and conclusions in this report are those of the authors and do not necessarily 

represent the official position of the Centers for Disease Control and Prevention.

Division of Tuberculosis Elimination 

National Center for HIV, Viral Hepatitis, STD, and TB Prevention

Centers for Disease Control and Prevention 

1600 Clifton Road NE, US 12-4

Atlanta, GA 30329

Phone: 404-639-8120

Internet Address: http://www.cdc.gov/tb/